Nursing Elites

1. Albert, a 35-year-old insulin-dependent diabetic, is admitted to the hospital with a diagnosis of pneumonia. He has been febrile since admission. His daily insulin requirement is 24 units of NPH. Every morning Albert is given NPH insulin at 0730. Meals are served at 0830, 1230, and 1830. The nurse expects that the NPH insulin will reach its maximum effect (peak) between the hours of:

• A. 1130 and 1330.
• B. 1330 and 1930.
• C. 1530 and 2130.
• D. 1730 and 2330.

Correct answer: C

Rationale: NPH insulin typically peaks 4-12 hours after administration, so a peak between 1530 and 2130 would be expected. Choice A (1130 and 1330) is too early for the peak effect of NPH insulin. Choice B (1330 and 1930) falls within the possible peak period but is not as accurate as choice C. Choice D (1730 and 2330) is too late for the peak effect of NPH insulin based on the typical peak timing.

2. To be effective, a nurse manager needs both managerial and leadership skills. Interpersonal activities have many concerns that overlap both leaders and managers. However, some interpersonal activities are needed by nurse managers, but are not specific duties of leaders. Which of the following is an interpersonal activity of nurse managers, but not necessarily all nurse leaders?

• A. Coaching
• B. Resource allocation
• C. Planning for the future
• D. Monitoring

Correct answer: B

Rationale: Resource allocation is an interpersonal activity specific to nurse managers because it involves managing the distribution of resources within the healthcare environment, which is not necessarily a duty for all leaders. While coaching, planning for the future, and monitoring are important skills for both leaders and managers, resource allocation is a task that is more specific to the managerial role of nurse managers.

3. Which of the following ethical principles is demonstrated when a nurse provides truthful information to a patient?

• A. Veracity
• B. Autonomy
• C. Justice
• D. Nonmaleficence

Correct answer: A

Rationale: The correct answer is A: Veracity. Veracity is the ethical principle of truthfulness and honesty in communication. When a nurse provides truthful information to a patient, it demonstrates integrity and respect for the patient's right to know the truth about their health condition and treatment. Choice B, Autonomy, refers to respecting the patient's right to make their own decisions. Choice C, Justice, involves fairness and equality in healthcare decisions. Choice D, Nonmaleficence, relates to the obligation to do no harm and prevent harm to the patient.

4. The client with newly diagnosed diabetes mellitus is receiving education from the nurse on managing blood glucose levels. Which statement indicates a need for further teaching?

• A. I will monitor my blood glucose levels regularly.
• B. I can eat whatever I want as long as I take my medication.
• C. I should exercise regularly to help control my blood sugar.
• D. I will rotate my injection sites to avoid tissue damage.

Correct answer: B

Rationale: Choice B indicates a need for further teaching because it suggests that the client can eat whatever they want as long as they take their medication, which is incorrect. Clients with diabetes mellitus need to follow a healthy and balanced diet in addition to taking their medication to effectively manage blood glucose levels. Choices A, C, and D are correct statements for managing diabetes. Monitoring blood glucose levels regularly, engaging in regular exercise to help control blood sugar, and rotating injection sites to avoid tissue damage are all important aspects of diabetes management.

5. A male client with type 1 diabetes mellitus asks the nurse about taking an oral antidiabetic agent. Nurse Jack explains that these medications are only effective if the client:

• A. Prefers to take insulin orally.
• B. Has type 2 diabetes.
• C. Has type 1 diabetes.
• D. Is pregnant and has type 2 diabetes.

Correct answer: B

Rationale: Oral antidiabetic agents are specifically designed for type 2 diabetes mellitus. Type 1 diabetes requires insulin therapy as the primary treatment due to the absence of endogenous insulin production. Therefore, these medications are not effective for individuals with type 1 diabetes like the male client in this scenario. Choice A is incorrect as oral antidiabetic agents are not about preference but rather about treatment efficacy. Choice D is incorrect as being pregnant does not impact the effectiveness of oral antidiabetic agents; they are primarily indicated for type 2 diabetes.

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